Introduction

Human rights are some of the universal fundamental rights that safeguard the life, liberty, and health of every human being. After the violent wars, and genocides of the last century, nations have come together to pledge to safeguard the rights of every citizen, prisoner of war, and foreigner alike. Moreover, the notorious medical experiments of the Nazis on human beings shocked the world after knowing the horrors endured by prisoners at their hands. Multiple conventions have made this a globally prevalent set of rights.

The health and social care facilities, being a critical part of society, are also required to observe all these fundamental human rights in all circumstances. The industry's customers, being vulnerable to attacks, make health and social care facilities a testing ground for ethics and human rights. There are several moral challenges and human rights breaches in the health and social care industry. Without proper management, they are very unlikely to go away anytime soon. In this article, we have listed some of the important human rights issues that are faced by the managers of these facilities.

What are human rights?

Ethicists define human rights as unchallengeable, fundamental rights that a human being is entitled to, regardless of class, country, ethnicity, gender, religion, etc. These rights are constituted simply because he or she is a human being. Legal scholars, on the other hand, conceptualise and refer to human rights as an international response to the aftermath of World War II's crimes against humanity. The infamous "Doctors Trial" after WWII is an example of the importance of human rights in the medical world. In the case of health and social care facilities, there are several human rights violations, threats, and moral stalemates that health care and social care managers must be aware of.

Human rights issues in healthcare and social care facilities

1. Abortion

Abortion is the intentional killing of an unborn human in the womb through chemical or surgical means. Abortion has been at the forefront of debate for many decades. While women's rights activists are campaigning in favour of abortions, religious organizations are campaigning against them. Apart from China, North Korea, and the USA, all other countries in the world have some form of laws against abortion, especially, outlawing late-term abortions. These laws vary according to provision, punishment, and exceptions. Many countries view induced abortions as the homicide of the foetus. Most countries have laws that can punish a murderer of double homicide if he kills a pregnant woman. The countries in favour of abortions state the right of a woman to terminate her pregnancy. All in all, this is more of an ethical issue than a medical one (Source: Legal Service India).

In some countries, abortions are causing unconventional problems. Severe male child preference in some countries and societies has led to mass female foeticide, resulting in severe abnormalities in gender balance. In countries like India, the scale of female foeticide has led to the outlawing of gender determination before birth and the introduction of new laws. India passed Pre-Conception and Pre-Natal Diagnostic Techniques Act (PCPNDT) in 1994 to ban and punish prenatal sex screening and female foeticide. However, even then, India's abortions have reached over 15 6 million abortions per year (Source: Wikipedia). It can be guessed through previous observations that a significant part of these is gender-specific abortions.

2. Adoption

Foster care facilities are a haven for neglected children and ageing parents. According to UNICEF, there are over 153 million orphan children in the world. These children are the primary victims of war, genocides, physical and sexual assaults, malnutrition, child labour, cold marriage, and several other social evils. Although not exclusively, a significant proportion of these children live in impoverished countries such as those on the African continent. The recent political crisis in Syria has led thousands of children to become orphans. In such cases, international and local governments aid them by taking them to orphanages. Though many of them are prone to substandard living conditions and abuses, they are sometimes better than living in the streets.

These children can be given a home, a family, and a better life than they deserve through adoption. There are no accurate sources that answer how many couples are waiting to adopt a child. Some sources estimate that over 2 million couples are open to adopting a child in America alone (Source: American Adoptions).

This, however, sheds light on the complexities and slowness of legal systems in adoption. Many couples vary in their waiting and lose their patience in the process. Though such laws make sure that a child will not get into the wrong hands, they also deprive many children of the love they deserve. Relaxing these laws without compromising the strict family requirements must be a number one priority for governments. But sadly, this is overlooked by most countries around the world (Source: PMC). Denying the better life to orphans is indirectly a grave human rights as well as children's rights' violation.

3. Mercy killing

Mercy killing, or euthanasia, was a term associated with compassion until Hitler showed the world how it could be used to exterminate whole races and religions. Euthanasia was outlawed globally after the Second World War. The establishment of international human rights bodies and their ratification by most of the world's nations has made the right to life the most important of all. Hence, for mental health patients, in a few countries like Canada, Netherlands, and Luxembourg, active euthanasia is legal, but in most countries, such acts are trialled under murder. Normally, those who want to undertake mercy killing give the reason to avoid the person's excruciating pain, despairing stages of terminal illness, inability to think or any similar patient in a coma. In most countries, none of these is considered reasonable. Select few countries have legalized passive euthanasia (Source: Wikipedia).

Mercy killing has been a subject of debate since time immemorial. Soldiers murdering their teammates to avoid capture and torture by the enemy, and families murdering their women to avoid capture and rape by others, have been at the forefront of such debates. However, in a healthcare facility, such false compassion becomes a human weakness. Even when a person requests a quick death, healthcare professionals face a deep moral struggle in their minds. Killing someone is against the intention and scope of the medical profession and violates the oaths of medical practitioners. Hence, such acts are generally discouraged by the healthcare industry even in countries that permit mercy killing. In other countries, these are taken out of the hands of healthcare workers and into the hands of the legal system.

4. Privacy leaking

In the age of digitalization, information has become the new oil. Until recently, search engines and social media sites sold personal data to third parties for additional profits. Many such sites are fined by governments for selling private data (Source: BBC). This regime operates both online and offline. From login credentials to secret military documents, every piece of data is at the risk of hacking or unethical selling. The healthcare industry faces this risk. Due to the higher vulnerability of patients, they can be used for unethical advertising or used in organised crimes such as organ harvesting upon the death of patients. Besides these, nobody wants their health problems to become public. Some STDs and mental health disorders can create a feeling of insecurity in patients. Revealing this online can be a disaster for their mental health. This is a violation of the patient's right to privacy. In most cases, healthcare facilities can be sued for the leaking of such critical information.

5. Misuse of poverty and exploitation

Underprivileged, illiterate, or poor individuals are exploited by healthcare facilities or through middlemen without the knowledge of healthcare facilities. This is done for several purposes.

Organ harvesting

Approximately 10% of organ transplants are illegal (Source: PMC). Organ harvesting has somehow become an unethical, underground business. Often, those in need of money are exploited to sell their organs. Human trafficking victims, orphans, and mental health patients are also exploited for organs with or without the cooperation of healthcare facilities.

Surrogacy

Due to the complexities in adoption, many couples have resorted to surrogate mother pregnancies. As commercial surrogacy is outlawed in most countries, they look for a few countries where it is legal. Currently, commercial surrogacy is legal in India, Ukraine, and California while it is illegal in England and many states of the United States. Australia recognizes only altruistic surrogacy i.e., non-commercial surrogacy through relatives (Source: PMC).

Commercial surrogacy in India has become an unethical business run by middlemen. Often, poor, illiterate, or desperate women are exploited by these middlemen. These women are paid little, forced to be moved into middlemen-controlled-hostels to avoid social taboos, and deprived of any medical insurance. Most of the money that a foreign couple pays is gobbled up by these middlemen. This leaves women strained because of the pregnancy and open to further exploitation. Human trafficking victims are also used by these middlemen as there are no laws that regulate the whole process. In the end, the couple who paid for surrogacy is often left to fight long legal battles in their countries due to the unnatural delivery of their baby in a foreign nation.

Forced sterilisation

Population control has become a major agenda for many governments. Many governments have tried and failed to forcefully sterilise their citizens in the past. As a result, to compensate for the government targets, some healthcare facilities have resorted to covert methods. Some hospitals have placed IUDs inside women without their knowledge. This is done shortly after a woman gives birth without her consent or knowledge (Source: Times of India).

Unethical clinical trials

Experimenting with drugs that are not approved, or in development stages on patients is a major human rights violation. Various clinical trials across many countries have violated human rights by not obtaining consent from the participants. Phase III trials were conducted on individuals without their knowledge, resulting in the deaths of many patients. From research on induced ovulation to HIV AIDS, patients were used by companies and healthcare facilities without their consent or knowledge. In some trials, poor record-keeping and overdosing on drugs have led to the deaths of many informed participants. This is a grave human rights violation (Source file: Somo.nl).

6. Assaults

Assaults on social care facilities' staff by patients

Mental health facilities are notorious for assaults on their staff or caretakers. According to PMC, 24 - 80% of psychiatric nuns have experienced an event of violence during their service. Also, violent patients attack each other, causing bodily harm to other patients that come in their way. In rare cases, this infighting has led to the deaths of fellow patients.

Assaults on doctors for neglect or death of patients by relatives

Healthcare facilities are at risk of attacks from patients and their relatives. Especially in critical conditions where a patient gets operated on without the consent of guardians, if the operation results in the death of the patient, the hospital becomes vulnerable to attacks. Without the consent of guardians, lawsuits can force surgeons to end up in jail in such cases.

Sexual assaults on staff

Sexual assaults are one of the most underrated but highly prevalent human rights violations in healthcare and social care facilities. These assaults threaten all the staff, administration, and patients. Though not studied for its prevalence, sexual assaults in health and social care facilities are not uncommon (Source: Damore Law).

7. Expensive and counterfeit drugs

Source: Myriam Zilles Unsplash

Lastly, modern medicine, surgeries, and identifying the underlying cause cost more than an average individual can afford. Many rich countries, medical companies, and medical equipment manufacturers have patents with extravagant conditions that limit poor countries from access to these services. These countries, companies and manufacturers are playing monopoly for profit at the cost of the lives of patients in poorer countries (Source: PMC).

Though an abnormal incidence, the pandemic has been proof of the costly medical affairs of the industry. There were several human rights violations during the peak of the pandemic. From counterfeit oxygen cylinders sold to desperate families for a fortune, to the use of clinical drugs that were under development without the knowledge of patients. Counterfeiting of drugs, medical instruments, and even fake healthcare practitioners are some of the biggest problems in the healthcare industry of developing countries. Giving such counterfeits to patients causes serious side effects and deprives them of true healthcare. This can even lead to hospitalisation and in some cases, the deaths of patients.

Conclusion

Human rights violations and issues in health and social care facilities are plenty. It happens to patients of all ages, ethnicities, and nationalities. From abortion of a foetus to organ harvesting of exploited human beings for profit, the healthcare system is still facing many such social evils. Clinical trials without consent from the patients are a grave human rights violation. This often goes unnoticed due to poor record-keeping. In cases where patients die due to the side effects, there is little the legal systems can do against the healthcare system. Without clear laws and regulations and the initiative by governments and law enforcement departments, these are very unlikely to go away any time soon.

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